Learn what MMI means, what happens after, and how it might impact your work injury claim
Maximum medical improvement (commonly abbreviated as “MMI”) is a term that is often used in a workers’ compensation case and has a very important meaning. MMI can mean different things in different states, and it has important legal ramifications.
In this article, we will explore what MMI means, how it can affect your workers’ compensation case in Georgia, and how it can impact the resolution of your claim.
Definition of MMI
A basic definition of maximum medical improvement is when the injured worker’s on the job injury has improved as much as is medically possible. The injured worker may experience both the disability and the pain resulting from the injury for the rest of their life, but a medical professional has determined that they will not continue to get better because they have reached the maximum improvement.
MMI may occur while an injured worker is still receiving treatment because the treatment’s purpose may be to maintain a certain level of functionality. Sometimes treatment can be ongoing if it deals with pain management.
How permanent partial disability benefits are calculated
Once a person has reached maximum medical improvement, they are assigned a permanent partial disability rating. This rating is calculated into dollars by a formula that has been established by the Georgia state legislature.
In Georgia, each body part is worth a different amount of weeks of disability benefits. The schedule is as follows:
Georgia permanent partial disability (PPD) chart
|Body part||Weeks of compensation (rating)|
|Upper extremity (arm, elbow, etc.)||225|
|Lower extremity (leg, knee, etc.)||225|
|Any other toe||20|
|Loss of hearing, one ear||75|
|Loss of vision||150|
|Whole body (neck, back, multiple body parts at once)||300|
To determine the dollar value of the permanent disability rating, insurers multiply the rating by the workers’ compensation average weekly wage.
For example, if an individual injured their right knee and was assigned a ten percent (10%) rating, and they had a workers’ compensation rate of $500 per week, then they would be entitled to $11,250.00.
Georgia law (O.C.G.A. 34-9-263) specifically addresses permanent partial disability in Georgia.
How MMI affect workers’ compensation
There are two very important factors about maximum medical improvement in Georgia that you should be aware of.
- The authorized treating physician is the individual who determines whether or not the injured worker has reached maximum medical improvement.
- Just because an individual has reached maximum medical improvement does not mean that they are no longer entitled to weekly indemnity benefits.
Let’s deal with the first factor now.
Only an authorized treating physician can determine MMI
MMI is a condition that an injured worker reaches after an on the job injury. It is not a state of mind, nor place that an individual can physically go to. During an appointment with the injured worker, the authorized treating physician can make a determination that the individual has improved as much as they are going to from their on the job injury.
Once again, let’s be clear, MMI does not mean that the injured worker is better — it just means that the injury has improved as much as it is going to in the opinion of the authorized treating physician.
The injured workers’ employer cannot make a determination that injured worker has, or should have, reached maximum medical improvement. If they do attempt to make this claim, understand that it has no legal effect on your claim.
Furthermore, physical therapists or nurse case managers also cannot legally determine when an injured worker has reached MMI. Only the authorized treating physician can make the determination that the injured worker has reached maximum medical improvement, and then assign a rating.
Sometimes, an injured worker feels as though they are all better and that they are as good as they are going to get. This is NOT a medical determination that the injured worker can make on their own. There may be alternative treatments that the authorized treating physician has yet to try which can improve the medical condition of the injured worker. Furthermore, just because the injured worker “feels” all better, they may be in a very precarious medical state which can deteriorate quickly and cause further injury if they insist on performing their normal job duties.
MMI does not necessarily mean that disability benefits should stop
Secondly, when an injured worker in Georgia reaches maximum medical improvement, it does not change their eligibility to receive temporary total or temporary partial disability benefits. Note that this is different than some surrounding states such as Tennessee and Florida. In those states, an individual is no longer eligible for temporary total or temporary partial disability benefits once they have reached MMI. Once MMI has been reached, injured workers in those states are then only eligible to receive permanent partial disability benefits.
Georgia has a much better system, especially when it comes to maximum medical improvement.
Think about it:
Just because an individual has reached maximum medical improvement, it does not mean they are able to work. The injured worker should therefore still be able to receive indemnity (wage loss) benefits while they are unable to work because of their on the job injury. At a certain point, they may have healed as much as they possibly can, but they still may not be able to work in their prior position.
How MMI can impact the resolution of your claim
Many times, when an individual has reached MMI, it may be time to settle the case. The reason for this resolution is because the medical treatment has either wound down or plateaued. The injured worker may have already received the most expensive medical treatment and they know what type of injury they will be living with for the remainder of their lives.
It’s important to discuss your medical treatment with your attorney at all times so they can determine when is the best time to resolve your claim.
Because maximum medical improvement can only be determined by the authorized treating physician, it is very important to choose a doctor who will respect and listen to your needs and concerns.
If you have any questions about maximum medical improvement, don’t hesitate to contact the experienced Georgia workers’ compensation attorneys at Gerber & Holder Law.